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Teaching Self-reflection Skills to Children and Teens on the Autism Spectrum

"How can I help my child with autism (high functioning) to make better decisions?"

The ability to weigh options and make decisions are skills that all children need to possess. If we look closely to what those skills are and the building blocks that are needed for them, one crucial factor is present: the ability to self-reflect. Self-reflection is a necessary component to focus, decision-making, prioritization and action.

For example: What might be the best career for me? Why should I get into a relationship with this person? What can I do to make myself happy? At the heart of all these questions is the ability to introspect and find the answers.

In conventional Cognitive Behavioral Therapy (CBT) programs, clients are encouraged to self-reflect to improve insight into their thoughts and feelings, promoting a realistic and positive self-image and enhancing the ability to self-talk for greater self-control. However, the concept of self-consciousness is different for children with Asperger’s (AS) and High-Functioning Autism (HFA). There is often a qualitative impairment in the ability to engage in introspection (i.e., self-analysis).

Research evidence, autobiographies, and clinical experience have confirmed that many young people with AS and HFA lack an “inner voice” and think in pictures rather than words. They also have difficulty translating their visual thoughts into words. As one teenager with AS explained in relation to how visualization improves his learning (a picture is worth a thousand words), “I have the picture in my mind, but not the thousand words to describe it.” Some of these “special needs” children have an “inner voice” but have difficulty disengaging mind and mouth, thereby vocalizing their thoughts to the confusion or annoyance of others.

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

When parents attempt to teach self-reflection skills to their AS or HFA child, certain modifications need to be in place (e.g., a greater use of visual material and resources using drawings, role-play, and metaphor, and less reliance on spoken responses). Many young people on the autism spectrum have a greater ability to develop and explain their thoughts and emotions using other expressive media (e.g., typed communication in the form of e-mail or a diary, music, art, or a pictorial dictionary of feelings).

When talking about themselves, older teens and young adults with AS and HFA do not anchor their self-attributes in social activities and relationships, or use as wide a range of emotions in their descriptions like their “typical” peers do. They are less likely to describe themselves in the context of their relationships and interactions with other people. Thus, the teaching of self-reflection skills may have to be modified to accommodate a concept of self primarily in terms of physical, intellectual, and psychological attributes.

In self-reflection skills training, parents should attempt to adjust their child’s self-image to be an accurate reflection of his abilities and the neurological origins of his disorder. A bit of time needs to be allocated to explaining the nature of AS and HFA and how the characteristics account for his differences. As soon as the youngster has the diagnosis of AS or HFA, the parent needs to carefully and authoritatively explain the nature of the disorder to the family, but the affected youngster also must receive a personal explanation. This is to reduce the likelihood of inappropriate coping strategies to the child’s recognition of being different and concern as to why he has to see psychologists and psychiatrists.

The AS or HFA child also may be concerned as to why she has to take medication and receive “special education” at school. Over the last few years, there have been several publications developed specifically to introduce the youngster or teenager to their diagnosis. The choice of which book to use is the parent’s decision, but it is important that the explanations are accurate and positive. The child will perceive the diagnosis as it is presented.

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

If the approach is pessimistic, the reaction can be to trigger a depression or to reject the diagnosis and treatment. The parent also can recommend the child read some of the autobiographies written by other kids and teens on the autism spectrum. The subsequent discussion is whether and how to tell other people of the diagnosis, especially extended family, neighbors, and friends.



When an accurate perception of self has been achieved, it is possible to explore cognitive mechanisms to accommodate the AS or HFA child’s unusual profile of abilities and vulnerabilities, and to consider the directions for change in self-image. One approach is using the metaphor of a road map with alternative directions and destinations.




Kids and teens on the autism spectrum need the tools to help them hone their self-reflection skills. Here are some examples of prompts that parents can use to start engaging their youngster in reflecting about his or her thinking (brainstorm some additional ones, too):
  • During what activities do you become unaware of time passing?
  • How did you feel?
  • How do other people see you?
  • How do you most want to contribute to others?
  • If you were brave, what would you do?
  • Tell me something that made you happy today (use the other emotion words like frustrated, sad, angry).
  • What activities are you good at?
  • What are you passionate about?
  • What are you thinking right now?
  • What are your best gifts?
  • What are your dreams?
  • What are your goals?
  • What could this person be feeling?
  • What could this person be thinking?
  • What do you do right?
  • What do you fear?
  • What do you hesitate to admit about yourself?
  • What do you like to play with?
  • What do you love to do?
  • What do you most want to create?
  • What do you most want to give?
  • What do you value?
  • What do you want for your life?
  • What has gone well?
  • What has not gone well?
  • What have you always wanted to try?
  • What have you most enjoyed doing in your life?
  • What is challenging for you?
  • What is the next step?
  • What is your best contribution?
  • What made you excited today?
  • What motivates you?
  • What problem do you want to solve?
  • What takes energy away from you?
  • What was the best part of your day?
  • What was the least that you liked about your day?
  • When do you feel the most “natural”?
  • When is it time to take a break?
  • Where are you dissatisfied in your life?
  • Where are you meeting resistance right now?
  • Where do you get energy from?
  • Why do you like it? (best followed by “what makes you say that?”)

As much as these prompts are for the AS or HFA child, they are for parents, too. Parents should find the time to share their thoughts with their youngster and the entire family during family meetings (use some of the self-reflecting questions above as part of the meeting’s agenda).

Parents need to let everyone know what they are thinking and feeling and make it visible. In this way, the AS or HFA youngster realizes that the self-talk that goes on in her head is normal – and sharing it with her family is important. It also gives family members the opportunity to talk about not just what makes them happy, but more importantly, the deep, dark and ugly thoughts that keep them awake at night and in a state of anxiety. Self-reflection is not just about building self-esteem, it is also being able to share negative thoughts. Thus, parents will do well to give their youngster the chance to reflect on his fears – and face them.

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book


==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism

Part 8: Teaching Strategies for Students with Asperger’s and High-Functioning Autism – Restricted Range of Interests

Kids with Asperger’s (AS) and High-Functioning Autism (HFA) have eccentric preoccupations or odd, intense fixations (e.g., obsessively collecting unusual things). They tend to: ask repetitive questions about interests; follow own inclinations regardless of external demands; have trouble letting go of ideas; relentlessly "lecture" on areas of interest; and, sometimes refuse to learn about anything outside their limited field of interest.

Programming Suggestions for Teachers:

1. Use the AS or HFA youngster's fixation as a way to broaden his repertoire of interests. For example, during a lesson on rain forests, the student who is obsessed with animals can be led to not only study rain forest animals, but to also study the forest itself since this is the animals' home. The student can then be motivated to learn about the local people who are forced to chop down the animals' forest habitat in order to survive.

2. Use of positive reinforcement selectively directed to shape a desired behavior is a crucial strategy for helping the youngster with AS or HFA. These “special needs” kids respond well to compliments (e.g., in the case of a relentless question-asker, the teacher can consistently praise the child as soon as she pauses – and congratulate her for allowing others to speak). These kids should also be praised for simple, expected social behavior that is taken for granted in “typical” kids.



3. Some kids with AS and HFA will not want to do assignments outside their area of interest. Firm expectations must be set for completion of classwork. It must be made very clear to the youngster that he is not in control – and that he must follow specific rules. At the same time, though, meet the child halfway by giving him opportunities to pursue his own interests.

4. AS and HFA students can be given assignments that link their special interest to the subject being studied. For example, during a social studies lesson about a specific country, a youngster obsessed with trains can be assigned to research the modes of transportation used by people in that country.

5. For particularly unruly kids on the autism spectrum, it may be necessary to initially individualize all assignments around their interest area (e.g., if the interest is dinosaurs, then offer grammar sentences, math word problems, and reading and spelling tasks about dinosaurs). Then, gradually introduce other topics into assignments.

6. Do not allow the AS or HFA youngster to incessantly discuss – or ask questions about – isolated interests. Limit this behavior by designating a specific time during the day when she can talk about this. For example, a youngster who is fixated on animals and has countless questions about the class pet turtle should be advised that she is allowed to ask these questions only during recesses. This can be part of her daily routine, and she may quickly learn to stop herself when she begins asking these kinds of questions at other times of the day.

Affective Education for Children and Teens on the Autism Spectrum

A major part of emotional development in “typical” (i.e., non-autistic) kids and teens is how they recognize, label, and control the expression of their feelings in ways that generally are consistent with social norms (i.e., emotional control). Self-regulation of feelings includes recognition and description of feelings. Once a youngster can articulate an emotion, the articulation already has a somewhat regulatory effect.

Typical kids are able to use various strategies to self-regulate as they develop and mature. They begin learning at a young age to control certain negative feelings when in the presence of grown-ups, but not to control them as much around friends. By about age 4, they begin to learn how to alter how they express feelings to suit what they feel others expect them to express.



By about age 7 to 11 years, “typical” kids are better able to regulate their feelings and to use a variety of self-regulation skills. They have likely developed expectations concerning the outcome that expressing a particular feeling to others may produce – and have developed a set of behavioral skills to control how they express their feelings. By the teenage years, they adapt these skills to specific social relationships (e.g., they may express negative feelings more often to their mom than to their dad because they assume their dad will react negatively to displays of emotion). “Typical” teens also have heightened sensitivity to how others evaluate them.

Unfortunately, young people on the autism spectrum do not develop emotionally along the same lines and time-frame as “typical” children do. Children with Asperger’s (AS) and High-Functioning Autism (HFA), after all, have a “developmental disorder” – their emotional age is younger than their chronological age. Thus, they must be taught emotion management and social skills. Affective education (i.e., teaching children about emotions) is an effective way to accomplish this goal.

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's
 
Affective education is a crucial stage in a course of Cognitive Behavioral Therapy (CBT) and an essential component for children and teens with AS and HFA. The main goal is to learn why one has emotions, their use and misuse, and the identification of different levels of expression.

A basic principle is to explore one emotion at a time as a theme for a project. The choice of which emotion to start with is decided by the Cognitive Behavioral therapist, but a useful starting point is happiness or pleasure. A scrapbook can be created that illustrates the emotion. For younger kids, this can include pictures of people expressing the different degrees of happiness or pleasure, but can be extended to pictures of objects and situations that have a personal association with the feeling, (e.g., a photograph of a rare rock for a child with a special interest in rock collecting).

For older teens, the scrapbook can illustrate the pleasures in their life. The content also can include the sensations that may elicit the feeling (e.g., aromas, tastes, textures). The scrapbook can be used as a diary to include compliments, and records of achievement (e.g., certificates and memorabilia). At a later stage in therapy, the scrapbook can be used to change a particular mood, but it also can be used to illustrate different perceptions of a situation.

If therapy is conducted in a group, the scrapbooks can be compared and contrasted. Talking about dinosaurs may be an enjoyable experience for one group member, but perceived as terribly boring for another. Part of affective education is to explain that, although this topic may create a feeling of well-being in the one participant, his attempt to cheer up another person by talking about dinosaurs may not be a successful strategy (perhaps producing a response that he did not expect).

One of the interesting aspects noticed is that group members with AS and HFA tend to achieve enjoyment primarily from knowledge, interests, and solitary pursuits, and less from social experiences, in comparison with “typical” group members. They are often at their happiest when alone.

Affective education includes the clinician describing – and the AS or HFA child discovering – the prominent cues that indicate a particular level of emotional expression in facial expression, tone of voice, body language, and context. The face is described as an information center for emotions. The typical errors that young people on the autism spectrum make include not identifying which cues are relevant or redundant, and misinterpreting cues. The clinician uses a range of games and resources to “spot the message” and explain the multiple meanings (e.g., a furrowed brow can mean anger or bewilderment, or may be a sign of aging skin; a loud voice does not automatically mean that a person is angry).

Once the key elements that indicate a particular emotion have been identified, it is important to use an “instrument” to measure the degree of intensity. The clinician can construct a model “thermometer,” “gauge,” or volume control, and can use a range of activities to define the level of expression. For instance, the clinician can use a selection of pictures of happy faces and place each picture at the appropriate point on the instrument.

During the therapy, it is important to ensure that the AS or HFA child shares the same definition or interpretation of words and gestures and to clarify any semantic confusion. Clinical experience has indicated that some young people on the spectrum can use extreme statements (e.g., “I am going to kill myself”) to express a level of emotion that would be more moderately expressed by a “typical” child or teen. During a program of affective education, the clinician often has to increase the AS or HFA child's vocabulary of emotional expression to ensure precision and accuracy.




The education program includes activities to detect specific degrees of emotion in others – but also in oneself – using internal physiologic cues, cognitive cues, and behavior. Technology can be used to identify internal cues in the form of biofeedback instruments (e.g., auditory EMG and GSR machines). The AS or HFA child – and those who know him well – can create a list of physiologic, cognitive, and behavioral cues that indicate an increase in emotional arousal. The degree of expression can be measured using one of the special instruments used in the program (e.g., the emotion thermometer). One of the aspects of the therapy is to help the child perceive his “early warning signals” that indicate emotional arousal that may need cognitive control.

When a particular emotion and the levels of expression are understood, the next component of affective education is to use the same procedures for a contrasting emotion. For example, after exploring happiness, the next topic explored could be sadness; feeling relaxed could be explored before a project on feeling anxious. The child is encouraged to understand that certain thoughts or emotions are “antidotes” to other feelings (e.g., some activities associated with feeling happy may be used to counteract feeling sad).

Some young people with AS and HFA can have considerable difficulty translating their feelings into conversational words. There can be a greater eloquence, insight, and accuracy using other forms of expression. The clinician can use prose in the form of a “conversation” by typing questions and answers on a computer screen, or by using certain techniques (e.g., comic strip conversations that use figures with speech and thought bubbles). When designing activities to consolidate the new knowledge on emotions, one can use a diary, e-mail, art, or music as a means of emotional expression that provides a greater degree of insight for both the child and clinician.

Other activities to be considered in affective education are the creation of a photograph album that includes pictures of the child and family members expressing particular emotions, or video recordings of the child expressing her feelings in real-life situations. This can be particularly valuable to demonstrate her behavior when expressing anger.

Another activity entitled “Guess the message” can include the presentation of specific cues (e.g., a cough as a warning sign, a raised eyebrow to indicate doubt, etc.). It is also important to incorporate the AS or HFA child's special interest into the program (e.g., a child whose special interest is the weather can express his emotions as a weather report).

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

Emotional Flooding—

The opposite of emotional control is emotional flooding, which is characterized as overwhelming and intense feelings that can't be controlled. During an episode of emotional flooding, the autistic child's rational mind is disconnected, his nervous system is saturated, and his prefrontal cortex ceases to exercise its controlling function. Flooding may turn into panic and fear, fight or flight. It takes a long time to come down from this heightened state, and afterward, the "special needs" youngster is often completely drained to the point of exhaustion.

Here is a 7-step plan that parents can use to deal with emotional flooding in their AS or HFA child:

1. Create signals your AS or HFA youngster can use to let you know he is about to have an episode of emotional flooding. Signals can give these kids a tool to put some space in between the reaction and their response. One 11-year-old boy with AS came up with the word “burning” to use when he felt himself getting ready to spin out-of-control. He would shout “burning, burning, burning.” His sister knew this was the signal to back off, and his mom knew this was the signal to intervene. It worked for him by giving him a few seconds before his emotions took over.

2. When your child is flooding, don’t leave him alone – but don’t try to take away his uncomfortable emotions either. If you have an AS or HFA adolescent, give him some distance until he is ready to talk.  With a younger kid, wait and listen for a shift in the intensity, and then step-in to help soothe. Sometimes you can directly ask if your child needs help to feel better (e.g., “I notice you are really upset. Do you need some help to calm down?”). If your child is not ready, he will let you know. But if he is ready, you will get a nod yes, at which point you can make some moves to soothe. When an AS or HFA youngster is out-of-control emotionally, she needs your help to get her equilibrium back. You can’t problem solve until this has been accomplished. This is true even if the emotional flooding has occurred as a result of some disciplinary measure.

3. Understand the difference between emotional flooding and a child’s drama-driven display that is created to get something. If you have a youngster that you really feel uses emotional flooding strategically to get a particular response out of you, then back off until the intensity dies down, and then offer some assistance (but don’t give in to an unreasonable demand). If your youngster is using flooding manipulatively, and she is not successful in getting the results she is after, she will eventually stop. The goal here is to help your youngster learn to self soothe and problem solve.

4. Help your youngster move from (a) acting out intense emotions to (b) labeling and describing them verbally. Words help to diffuse and give a youngster some tools to begin regulating emotions. The better able your youngster is at describing in detail her emotional state or reactions, the better she can regulate them.

5. Never attempt to suppress negative emotions. No child can help the feelings he has. He can only learn how to best manage them. Getting rid of negative emotions prematurely just sends them underground, where they can gain intensity and explode later during an unrelated event.

6. Try to figure out what the trigger is for your child’s emotional flooding. Sometimes triggers are obvious (e.g., reactions to change of routine). But, sometimes out-of-control behavior is a reaction to something that isn’t so obvious in the current situation.  For example, an AS or HFA youngster who has been repeatedly rejected and/or teased by peers may be overly-sensitive to even the slightest hint of criticism from parents.

7. When emotional flooding has run its course and the child is calm, parents can attempt to address the problem in question. Encourage your child to talk, and then reflect back to him what you heard (i.e., provide feedback). In this stage of the game, it’s more important that your child feels understood than for you to correct his way of thinking. Let him play out the scenario, and then show you understand his point of view. After you have accomplished this, you can start helping him to come up with a solution to the problem that caused him to “flood” in the first place.

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book


==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism


COMMENTS:

•    Anonymous said… I needed this today. My so. Had an "emotional flooding" moment and let me know that kids walk away from him or ignore him completely when he tries to talk to them. How do i get services for social and cognitive behavior help at age 14?
•    Anonymous said… I wish we could have found people that actually knew how to do this. My daughter is now 22 and things have not gotten any easier. We put her in 3 different places when she was younger and none of them helped at least not long term.
•    Anonymous said… I would like to know if anyone here has a HFA adult age now that cusses them out constantly and nothing at all is ever their fault.
•    Anonymous said… My daughter is 18 and heading to college in the fall. I've always wanted her to be able to get this kind of help. I've tried in my own way, but it's hard. So nervous to let her go. Don't give up smile emoticon
•    Anonymous said… Once my son got to high school...he became more discerning of people's motives. After a while he could care less what anyone said or thought about him (negatively ). He had a few friends in Anime Club and pretty much ignored the bullies.
•    Anonymous said… So very true!! It breaks my heart every time our son THINKS a kid is either making fun of him, when he or she is not and it's just "typical kid banter". Or like recently, when a boy at his middle school was taking GREAT advantage of him because he knew how desperately our son wanted friends. He just didn't see the insincere behavior and thought it was what friendship is supposed to be. Just killed me when he figured it out after we talked to him about the "bad thing" that happened. frown emoticon But there is a bright spot to this. It can be taught and learned, understanding certain social cues and how to watch for them. He's getting there. It's just that, for so many others, this sort of thing is instinctive. For our kiddos, we have to help them, point things out, role play, help them learn it. Merry Christmas everyone!!!
•    Anonymous said… That's is all we all can do with a child with Aspergers is try in our own way. What worked yesterday may not work today so we just keep trying. smile emoticon
•    Anonymous said… This is exactly my son too
•    Anonymous said… You are not alone, my son is 11. Place after place he went and all they would do is CBT. Now we live where there is an Autism center and he's too old, their age cut off is 8.
•    Anonymous said…. It's hard when you just want to make everything ok. Milan is not on the spectrum but he struggles socially and it's so hard to watch or answer why his five year old brother has so many friends and party invites

Please post your comment below…

Part 7: Teaching Strategies for Students with Asperger’s and High-Functioning Autism – Impairment in Social Interaction

Young people with Asperger’s (AS) and High-Functioning Autism (HFA):
  • are easily taken advantage of (e.g., do not perceive that others sometimes lie or trick them)
  • are relatively naïve
  • are sometimes labeled "little professor" because speaking style is so adult-like and pedantic
  • exhibit poor ability to initiate and sustain conversation
  • have difficulty judging "social distance"
  • have difficulty understanding jokes, irony or metaphors
  • have well-developed speech, but poor communication skills
  • may appear insensitive and lacking tact
  • may be extremely egocentric
  • may not like physical contact
  • may use inappropriate gaze and body language
  • may use monotone or stilted, unnatural tone of voice
  • often misinterpret social cues
  • show an inability to understand complex rules of social interaction
  • talk “at” people instead of “to” them
  • usually have a desire to be part of the social world, but don’t have the skills to do so

Programming Suggestions for Teachers:

1. Protect the youngster from bullying and teasing.

2. Older students with AS and HFA can benefit from a "buddy system." The teacher can educate a sensitive classmate about the situation of the youngster with AS or HFA and seat them next to each other. The classmate could look out for the “special needs” youngster on the bus, during recess, in the hallways, etc., and attempt to include him or her in school activities.

3. Most young people with AS and HFA want friends, but simply do not know how to interact. They should be taught how to react to social cues and be given repertoires of responses to use in various social situations. Teach these kids what to say and how to say it. Model two-way interactions and let them role-play. Their social judgment improves only after they have been taught rules that “typical” children pick up intuitively.



4. Young people with AS and HFA tend to be reclusive. Therefore, the teacher must foster involvement with others. Encourage active socialization, and limit time spent in isolated pursuit of interests. For instance, a teacher's aide seated at the lunch table could actively encourage the youngster with AS or HFA to participate in the conversation of his classmates not only by soliciting his opinions and asking him questions, but also by subtly reinforcing other kids who do the same.

5. In the higher age groups, attempt to educate peers about the youngster with AS or HFA when social ineptness is severe by describing her social problems as a true “disorder.” Praise classmates when they treat her with compassion. This task may prevent scapegoating, while promoting empathy and tolerance in the other kids who may be “different.”

6. Emphasize the proficient academic skills of the youngster with AS or HFA by creating cooperative learning situations in which his reading skills, vocabulary, memory, etc., will be viewed as an asset by classmates, thereby engendering acceptance.

7. Although they lack personal understanding of the emotions of others, kids with AS and HFA can learn the correct way to respond. When they have been unintentionally insulting, tactless or insensitive, it must be explained to them why the response was inappropriate and what response would have been correct. Children with AS and HFA must learn social skills intellectually, because they lack social instinct and intuition.

Struggling with your "special needs" student? Click here for highly effective teaching strategies specific to the Aspergers and HFA condition.

2024 Statistics of Autism in Chinese Children

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